Physical activity and sleep quality in relation to mental health among college students

Psychosocial factors and physical function in higher education students with musculoskeletal pain attending direct access physiotherapy: An observational longitudinal study

INTRODUCTION

Musculoskeletal pain and mental health problems commonly coexist in students, potentially impacting physical function. However, there is a lack of follow-up studies investigating the relationship between changes in psychosocial stress and physical function among higher education students.

OBJECTIVE

We examined whether psychosocial factors at baseline or the change in psychosocial profile over 3 months were associated with physical function at a 3-month follow-up in higher education students with musculoskeletal pain.

METHODS

Participants were students attending direct access physiotherapy due to musculoskeletal pain (n = 133). Psychosocial factors were measured with the Short Form of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-SF), and with the Mental Health Index (MHI-5). Physical function was measured using the Patient-Specific Functional Scale. The associations were analyzed using linear regression analysis adjusted for gender and age.

RESULTS

A higher load of psychosocial factors, measured by the ÖMPSQ-SF at baseline, was associated with lower physical function at the 3-month follow-up, regression coefficient beta (ß) -0.557, 95% confidence interval (CI) [-1.04, -0.08]. No association was found between physical function and the MHI-5. The median of the ÖMPSQ-SF score decreased seven points (p < .001) between the baseline (32, interquartile range (IQR) 25-42) and 3-month follow-up (25, IQR 17-38). A reduction in the ÖMPSQ-SF score was associated with better physical function at 3 months (ß -0.332; CI 95% -0.50 to -0.16).

CONCLUSION

A reduced psychosocial load over three months is associated with better physical function in students with musculoskeletal pain. Addressing psychosocial factors appears to be important in direct access physiotherapy for patients with reduced physical function.

Sleep quality of college students in Fujian and its influencing factors: A cross-sectional study

AIM

This study aims to investigate college students' sleep quality, explore the factors influencing it, and provide data support for further studies.

METHODS

College students in Fujian Province were chosen as the study sample using snowball sampling. Data was gathered from the participants through the utilization of a self-designed personal questionnaire, the Pittsburgh Sleep Quality Index(PSQI) scale, and the Mobile Phone Addiction Index (MPAI) scale. Binary logistic regression is utilized to assess the sleep quality of college students and identify risk factors.

RESULTS

A total of 971 participants were included in this study. The mean total PSQI score was 4.52 ± 3.17. There were 310 students with poor sleep quality and the detection rate was 32.0%. The multivariate logistic regression analysis showed that smoking (OR(Odds ratio):1.832(1.076,3.118)), electronic product addiction(OR:2.861(1.928,4.246)), personal history of acute illness(OR:2.328(1.671,3.244)) were identified as independent risk factors.In turn, education (OR:0.594(0.456,0,772)) and parents without sleep problems (OR:0.533(0.361,0.787)) were protective factors.

CONCLUSION

College students in Fujian have some sleep problems. We should pay attention to the relationship between smoking, electronic product addiction, personal history of acute illness and sleep quality. Health policymakers should consider these factors to improve college students' sleep quality.

Evaluating the agreement between ChatGPT-4 and validated questionnaires in screening for anxiety and depression in college students: a cross-sectional study

BACKGROUND

The Chat Generative Pre-trained Transformer (ChatGPT), an artificial intelligence-based web application, has demonstrated substantial potential across various knowledge domains, particularly in medicine. This cross-sectional study assessed the validity and possible usefulness of the ChatGPT-4 in assessing anxiety and depression by comparing two questionnaires.

METHODS

This study tasked ChatGPT-4 with generating a structured interview questionnaire based on the validated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7). These new measures were referred to as GPT-PHQ-9 and GPT-GAD-7. This study utilized Spearman correlation analysis, Intra-class correlation coefficients (ICC), Youden's index, receiver operating characteristic (ROC) and Bland-Altman plots to evaluate the consistency between scores from a ChatGPT-4 adapted questionnaire and those from a validated questionnaire.

RESULTS

A total of 200 college students participated. Cronbach's α indicated acceptable reliability for both GPT-PHQ-9 (α = 0.75) and GPT-GAD-7 (α = 0.76). ICC values were 0.80 for PHQ-9 and 0.70 for GAD-7. Spearman's correlation showed moderate associations with PHQ-9 (p = 0.63) and GAD-7 (p = 0.68). ROC curve analysis revealed optimal cutoffs of 9.5 for depressive symptoms and 6.5 for anxiety symptoms, both with high sensitivity and specificity.

CONCLUSIONS

The questionnaire adapted by ChatGPT-4 demonstrated good consistency with the validated questionnaire. Future studies should investigate the usefulness of the ChatGPT designed questionnaire in different populations.

Life's essential 8 and specific cancer risk and mortality in men and women: a population-based cohort analysis of 332,417 United Kingdom participants

BACKGROUND

This study aimed to explore the association between Life's Essential 8 (LE8) and the risk of cancer occurrence and cancer-associated mortality across 24 cancer types. The cardiovascular health (CVH) score is constructed based on the overall LE8 score, providing a more direct measure of CVH and its potential relationship with cancer risk.

METHODS

This cohort enrolled participants from a prospective cohort of the United Kingdom Biobank, including individuals aged 37-73 years, with 332,417 cancer-free participants. CVH scores were assessed using the LE8 metrics. The primary outcome of this study was the risk of cancer events, and the secondary outcome was cancer mortality. Competitive models were used to examine the associations between each 10-point increment in the CVH score and the outcomes, with stratified analyses conducted for both men and women to assess sex differences.

RESULTS

The mean CVH score was 64.4(55.6,72.5) in men and 70.0 (61.2,78.1) in women (P < 0.001). During a mean follow-up time of 12.0 years, 12.32% (95% confidence interval [CI]: 12.21-12.43%) of participants developed cancer, and 2.13% (95% CI: 2.08-2.18%) died from cancer. A 10-point rise in CVH score was negatively associated with overall cancer occurrence in men (hazard ratio [HR]: 0.97, 95% CI: 0.96-0.98) and women (HR: 0.96, 95% CI: 0.95-0.97), along with reduced cancer mortality risk in both sexes. Moreover, sex differences were observed in the impact of a 10-point CVH increase on esophageal, gastric, colorectal, and liver cancers.

CONCLUSIONS

Lower CVH scores were associated with an increased overall cancer risk and higher cancer-related mortality, highlighting the need for cancer screening in patients with low CVH scores.

Smartphone addiction and sleep quality in the physical activity-anxiety link: a mediation-moderation model

Background

Anxiety symptoms are common among university students in China, posing challenges to mental health. Physical activity may reduce anxiety, but the mechanisms are not fully understood. This study examines how smartphone addiction acts as a mediator and sleep quality as a moderator in the relationship between physical activity and anxiety, aiming to offer theoretical insights and practical strategies for mental health interventions.

Methods

This cross-sectional study was conducted in September 2023 at Guangxi University. A stratified sampling method was used to approach 719 students from diverse physical education classes to distribute questionnaires, and 527 valid questionnaires were returned. Validated instruments included the International Physical Activity Questionnaire-Short Form (IPAQ-SF), Smartphone Addiction Scale-Short Version (SAS-SV), Pittsburgh Sleep Quality Index (PSQI), and Self-Rating Anxiety Scale (SAS). Data analysis involved standardization, descriptive statistics, Pearson correlation, normality testing, mediation and moderation analyses, and Bootstrap validation.

Results

(1) Physical activity was negatively correlated with smartphone addiction (r = -0.13, p < 0.01). (2) Smartphone addiction was positively correlated with poor sleep quality (r = 0.40, p < 0.01) and anxiety (r = 0.43, p < 0.01). (3) Poor sleep quality and anxiety were significantly correlated (r = 0.57, p < 0.01). (4) A masking effect occurred as the non-significant positive direct effect (β = 0.062) was nearly canceled out by the mediation of smartphone addiction (β = -0.058), inducing total effect near-zero. (5) Sleep quality significantly influenced the link between smartphone addiction and anxiety, especially in those with poorer sleep, where the impact of smartphone addiction on anxiety was stronger (β = 0.061, p = 0.036).

Conclusion

This study revealed a more complex relationship between physical activity and anxiety than initially hypothesized. Our findings further revealed the relationship between physical activity and university students' anxiety, and considered the mediating role of smartphone addiction between the two, as well as the moderating role of sleep quality in the relationship between mobile phone addiction and university students' anxiety.

The effect of social media use on suicidal ideation in college students: Mediation by daytime sleepiness and sleep quality

BACKGROUND

Social media use and daytime sleepiness are common among university students and have significant implications for their mental health. The aim of this study was to examine the effects of social media use on suicidal ideation among university students and to analyse the mediating effects of daytime sleepiness and sleep quality.

METHODS

A total of 5899 full-time undergraduate students were included in this study. Questionnaires were distributed and collected using the QuestionStar platform. Logistic regression analysis was used to examine the association between social media use, daytime sleepiness and sleep quality, and suicidal ideation among college students. The mediation model was tested using the bias-corrected percentile bootstrap method.

RESULTS

Among 4835 students, 612 (12.66 %) reported having had suicidal ideation. Regression analysis revealed that social media use (OR = 1.09, 1.05-1.12), daytime sleepiness (OR = 1.09, 1.06-1.11), general and poor sleep quality (OR = 1.89, 1.56-2.28; OR = 4.82, 3.76-6.18) were all significantly and positively associated with suicidal ideation. Furthermore, there was a chain-mediated effect of daytime sleepiness and sleep quality on the relationship between social media use and suicidal ideation.

LIMITATIONS

Causality could not be explored by cross-sectional studies, and future cohort studies are needed.

CONCLUSIONS

There was a chain-mediated effect between daytime sleepiness and sleep quality in the relationship between social media use and suicidal ideation. Therefore, it is recommended that students reduce their use of social media to improve their sleep quality and mental health.

Older cerebral small vessel disease and sleep disturbance: A diffusion tensor imaging study

OBJECTIVE

This study examined the relationship between diffusion tensor imaging indicators and brain network characteristics in patients with cerebral small vessel disease (CSVD) with (CSVD + S) and without (CSVD-S) sleep disturbance. We explored the feasibility of using these imaging biomarkers to investigate the pathophysiological mechanisms underlying sleep disturbance in patients with CSVD.

METHODS

A total of 146 patients with CSVD and 84 healthy controls were included. Sleep quality was assessed using polysomnography and the Pittsburgh Sleep Quality Index. Tract-based spatial statistics and graph theory were applied to compare white matter lesions and brain network characteristics, which were then used for backpropagation artificial neural network (BPANN) analysis.

RESULTS

Compared with the control group, the CSVD + S group showed a decrease in total sleep time and sleep efficiency, as well as higher values for sleep onset latency, wake after sleep onset, and non-rapid eye movement sleep stage 1. Both the CSVD + S and CSVD-S groups exhibited reduced fractional anisotropy and structural connectivity strength. However, the CSVD + S group showed increased mean diffusivity in affected fiber bundles (the anterior thalamic radiation, frontal occipital fasciculus, and superior longitudinal fasciculus) in key brain regions, such as the thalamus and frontal lobe, that regulate sleep and wakefulness. In addition, the CSVD + S group showed significant impairments in global, node, and small-world attributes. The BPANN model successfully predicted sleep disturbance in patients with CSVD.

CONCLUSION

Our findings support the possibility that white matter abnormalities in subcortical neural circuits and microstructural and functional changes in brain connections underly CSVD sleep disturbance.

Association between movement behaviors and depression among vocational school students with different sleep duration - a study based on the isotemporal substitution model

The isotemporal substitution model can be used to explore the impact of the isotemporal substitution of different behaviors on human health. The association between sleep duration and mental health may be non-linear, but the relationship between the isotemporal substitution of movement behaviors and mental health in different sleep duration groups has not been explored. A questionnaire survey was conducted among Grade 1-3 students in 14 vocational schools in China, and 8149 valid questionnaires were obtained, of which 58.80% were in sleep-insufficient group, and 32.56% were detected with depression symptoms. The isotemporal substitution model was used for analysis. In the sleep-insufficient group, substituting 10 minutes/day of vigorous physical activity (β=-0.318, 95%I = -0.498~-0.138), walking (β=-0.254, 95%I = -0.381~-0.126) and sedentary behavior (β=-0.234, 95%I = -0.337~-0.130) with isotemporal moderate physical activity, or substituting vigorous physical activity (β=-0.465, 95%I = -0.577~-0.353), moderate physical activity (β=-0.147, 95%I = -0.263~-0.031), walking (β=-0.400,95%I = -0.476~-0.324) and sedentary behavior (β=-0.380,95%I = -0.434~-0.327) with isotemporal sleep, were negatively associated with depression; and substituting moderate physical activity (β = 0.318, 95%CI = 0.138 ~ 0.498) and sleep (β = 0.465, 95%CI = 0.353 ~ 0.577) with isotemporal vigorous physical activity was positively associated with depression. In the sleep-sufficient group, replacing sedentary behavior (β=-0.129, 95%I = -0.244~-0.013) with equivalent moderate physical activity was negatively associated with depression; replacing moderate physical activity (β = 0.219, 95%CI = 0.101 ~ 0.338), walking (β = 0.112, 95%CI = 0.040 ~ 0.185) and sedentary behavior (β = 0.091, 95%CI = 0.058 ~ 0.124) with equivalent sleep was positively associated with depression. For the sleep-insufficient group, substituting vigorous physical activity, walking, and sedentary behavior with isotemporal moderate physical activity and sleep had greater negative association with depression than the sleep-sufficient group. In conclusion, for the sleep-insufficient group, the substitution that was largest negatively associated with depression was sleep for other behaviors, and for sleep-sufficient group it was moderate physical activity for other behaviors. In future interventions, the sleep-insufficient group may achieve greater effects than the sleep-sufficient group if they use moderate physical activity and sleep instead of other behaviors.

The association between sleep quality and anxiety symptoms: a cross-sectional study based on Tibetan university students at high altitude in China

Background

There have been more previous studies on sleep quality and anxiety symptoms among university students in plains areas. However, fewer studies have been conducted on Tibetan university students at high altitude. Analyzing the relationship between sleep quality and anxiety symptoms due to increased altitude may provide a reference for mental health promotion and intervention for Tibetan university students in high altitude areas.

Methods

Stratified whole cluster sampling was used. The pittsburgh sleep quality index (PSQI) scale was used to investigate the sleep quality of 4,777 university students at high altitude in China. The self-rating anxiety scale (SAS) was used to investigate anxiety symptoms. The chi-square test was used to compare the detection rates of anxiety symptoms among different groups, and logistic regression analysis was used to analyze the association between sleep quality and anxiety symptoms.

Results

The prevalence of anxiety symptoms among Tibetan university students at high altitude in China was 25.7%. The detection rate of anxiety symptoms among girls (28.4%) was higher than that of boys (22.1%), and the difference was statistically significant (χ 2 = 24.634, p < 0.001). The detection rates of anxiety symptoms among university students with sleep quality of "Good," "Medium" and "Poor" were 1.8, 4.8 and 39.2%, respectively, and the differences were statistically significant (χ 2 = 779.759, p < 0.001). Logistic regression analysis after adjusting for relevant covariates showed that the risk of anxiety symptoms was higher in the "Medium" (OR:3.479, 95%CI:1.946 ~ 6.221) and "Poor" (OR:44.817, 95%CI:29.175 ~ 68.847) groups, compared with the "Good" group. The same trend was observed in both men and women at the university level.

Conclusion

There is a close relationship between sleep quality and the occurrence of anxiety symptoms among Tibetan university students at high altitude in China. Improving sleep quality may have a positive effect on reducing the occurrence of anxiety symptoms among Tibetan university students at high altitude.

Invisible disabilities and health among U.S. postsecondary students

Objective: The current study compares the health behaviors and outcomes of students with three types of invisible disabilities-autism, ADHD or learning disabilities, and mental health conditions-to neurotypical students. Gender differences are also examined. Participants: Undergraduate college students (n = 2,822) at ten postsecondary institutions in Indiana. Methods: Students completed an online survey in spring 2021. Differences in health behaviors and outcomes based on disability status were estimated using linear and logistic regression models. Results: College students with invisible disabilities reported worse health than neurotypical students across a range of health behaviors and outcomes, for both physical and mental health. Students with mental health conditions reported worse health most consistently. There were few gender differences. Conclusions: Health-related programming targeted to students with invisible disabilities has received little attention in research on college student health. As this population grows, we recommend that institutions develop programs to address their specific health-related challenges and needs.

Physical Exercise and Sleep Quality Among Chinese College Students: The Mediating Role of Self-Control and the Moderating Role of Mindfulness

Although a few studies have examined the relationship between physical exercise and sleep quality, the underlying mechanisms of this association remain unclear. This study aims to investigate how and under what conditions physical exercise can promote the sleep quality among Chinese college students, with a focus on how self-control mediates and mindfulness moderates this relationship. Data were collected through convenient sampling from five universities in China, with a total of 1028 college students aged 16 to 29 participating in the study. Participants were recruited to complete the self-report questionnaires measuring their physical exercise, self-control, sleep quality and mindfulness. Results showed that physical exercise significantly and positively predicts sleep quality among Chinese college students. Further moderated mediation analyses indicated that self-control plays a significant mediating role, while mindfulness plays a moderating role in this relationship. Additionally, simple slopes analyses found that the moderating effect of mindfulness is more pronounced among individuals with lower levels of mindfulness compared to those with higher levels. The findings suggest that physical exercise can enhance sleep quality by improving self-control. Furthermore, physical exercise has a beneficial impact on self-control and sleep quality among college students with low mindfulness, while mindfulness itself exerts a distinct positive influence among those with high mindfulness.

Associations between mobile phone involvement, BMI levels, and sleep quality among Chinese university students: evidence from a multi-regional large-scale survey

Objective

This study aims to explore the association between mobile phone involvement, body mass index (BMI) levels, and the sleep quality of Chinese university students.

Methods

Using a cluster sampling method, we selected 17,085 university students from three universities in eastern, central, and western China as the study subjects. Demographic information such as age and sex were collected. The Pittsburgh Sleep Quality Index (PSQI) and the Mobile Phone Involvement Questionnaire (MPIQ) were utilized to measure their sleep quality scores and mobile phone involvement scores, respectively. Pearson correlation analysis, two-way ANOVA, and multiple linear regression were employed to examine the relationship between BMI levels, mobile phone involvement, and sleep quality.

Results

The results show that 15.87% (2,712 participants) are classified as overweight, and 18.45% (3,151 participants) are classified as obese. Additionally, 35.87% (6,125 participants) exhibit mobile phone involvement, while 57.94% (9,899 participants) reported poor sleep quality. Pearson correlation analysis indicates a significant negative correlation (p < 0.01) between sleep quality and both BMI levels and mobile phone involvement. Two-way ANOVA shows the significant effect of BMI levels (p < 0.001) and mobile phone involvement (p < 0.001) on sleep quality, and there is no interaction effect between the two. Additionally, the sleep quality of overweight and obese individuals is significantly poorer than that of those with normal weight (p < 0.05), while the sleep quality of overweight individuals is significantly lower than that of obese individuals (p < 0.05). Multiple linear regression analysis indicates that, after controlling for age and gender, both BMI (β = -2.69) levels and mobile phone involvement (β = -1.34) are significantly negatively associated with sleep quality (p < 0.001), accounting for 19% of the variance in poor sleep quality.

Conclusion

This study found that BMI levels and mobile phone involvement are both independently associated with sleep quality among Chinese university students. However, among individuals with excess BMI, although their sleep quality is worse than individuals with normal weight, overweight individuals may have poorer sleep quality than obese individuals. This study also revealed high rates of overweight and obesity, with over half of participants reporting poor sleep quality, highlighting the need for targeted interventions to address weight management and mobile phone usage to improve sleep health in this population.

Factors associated with caffeine intake among undergraduates: a cross-sectional study from Palestine

BACKGROUND

Caffeine is one of the world's most frequently consumed central nervous system stimulants. Moderate caffeine intake has beneficial health effects, while increased caffeine intake may have harmful effects in the human body. Existing literature indicated that undergraduates consume caffeine excessively. Till this date, little is known about the consumption pattern of caffeine among Palestinian undergraduates. Therefore, the current study aimed to estimate the percentage of caffeine consumption among Palestinian undergraduates, to assess their caffeine daily intake, and to identify factors associated with unsafe caffeine consumption.

METHODS

A cross-sectional study was conducted in Palestine between March and May 2022. Undergraduates were recruited by random sampling after a personal invitation. Undergraduates aged between 18 and 25 were included in the study, while those who were taking medications, had medical conditions affecting the data collection process, and had incomplete responses were excluded from the study. Caffeine consumption was assessed using a semi-quantitative food frequency questionnaire (FFQ) developed by the research team. The content validity of the FFQ was done by three reviewers. Also, a questionnaire was used to collect data related to sociodemographic characteristics, medical history, lifestyle habits, sleeping quality, physical activity, and psychological status. Data were analyzed through the descriptive statistics and inferential statistics (Chi-square test, Mann-Whitney test, and Kruskal-Wallis H test).

RESULTS

The final analysis included 486 undergraduates with a mean age of 20.1 ± 1.48 years. The majority of the undergraduates were female (65.0%) and single (89.5%). The sample was distributed almost equally between the first (26.3%), second (23.0%), third (22.8%), and fourth (18.7%) academic years, and only 44 undergraduates (9.1%) were in their fifth year. The vast majority of university students (96.5%) consumed caffeinated products, with coffee ranking first place. Nearly half of the participants (32.7%) exceeded the safe levels of caffeine consumption. Males, smokers, poor physical activity, higher Sleep Hygiene Index (SHI) scores, and greater anxiety, stress, and depression scores had significantly higher rates of unsafe caffeine intake than their peers (p < 0.05). The total caffeine consumption was significantly associated with gender, low household income, smoking status, physical activity level, SHI score, as well as anxiety (p < 0.05).

CONCLUSION

Caffeine consumption in the studied sample was significantly high and exceeded the safe levels. The current study revealed that unsafe caffeine consumption was more common among males, smokers, and physically active individuals. Caffeine intake was also linked to poor-quality sleep and higher psychological concerns. Therefore, educational programs are recommended to increase awareness of the adverse effects of high caffeine intake.

Predictors of depression among Chinese college students: a machine learning approach

BACKGROUND

Depression is highly prevalent among college students, posing a significant public health challenge. Identifying key predictors of depression is essential for developing effective interventions. This study aimed to analyze potential depression risk factors among Chinese college students using the Random Forest Algorithm (RFA) and to explore gender differences in risk patterns.

METHODS

A cross-sectional study was conducted with 10,043 undergraduate students from Guizhou Normal University. Thirty-three variables were analyzed using RFA. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), with a score of ≥ 16 indicating depression risk. The variables included sociodemographic characteristics, physical and psychological health indicators, behavioral and lifestyle factors, socioeconomic conditions, and family mental health history.

RESULTS

The RFA identified several factors associated with depression risk, with suicidal ideation, anxiety, and sleep quality exhibiting the strongest associations. Other significant predictors included academic stress, BMI, vital capacity, psychological resilience, physical fitness test scores, major satisfaction, and social network use. The model achieved an accuracy of 87.5% and an AUC of 0.927. Gender-stratified analysis suggested different patterns: physical fitness indicators showed stronger associations with depression risk among male students, while BMI was more strongly associated with depression risk among female students.

CONCLUSIONS

This cross-sectional study identified factors associated with depression risk among Chinese college students, with psychological factors showing the strongest associations. Gender-specific patterns were observed, suggesting the importance of considering gender differences when developing mental health interventions. However, longitudinal studies are required to establish causal relationships and validate these findings through intervention trials.

Self-control moderates the impacts of physical activity on the sleep quality of university students

The study was designed to examine the role of self-control as a moderator in the relationship between physical activity and sleep quality in a sample of 2274 college students. We employed the Physical Activity Rating Scale, the Pittsburgh Sleep Quality Index, and the Self-Control Scale to assess the variables. Our analysis revealed a significant correlation between physical activity levels and Pittsburgh Sleep Quality Index (r = - 0.541, p < 0.01). Furthermore, self-control was found to be a significant moderating factor (β = 0.001, p < 0.01), indicating that the effect of physical activity on sleep quality is influenced by an individual's level of self-control. Since higher Pittsburgh Sleep Quality Index scores indicate poorer sleep quality, the positive impacts of physical activity on sleep quality tended to diminish with increasing self-control levels. Conversely, the positive impacts of physical activity on sleep quality appeared to intensify as self-control levels decreased. Individuals with lower self-control seemed to benefit the most from increased physical activity, whereas those with higher self-control demonstrated superior sleep quality. The findings highlight the significance of fostering self-regulatory abilities alongside engaging in physical activity as a promising approach to improve sleep health in college students.

Relationships between personality traits, high school sports participation, and physical activity of college students in the United States

Objective: The study aimed to 1) examine relationships between contexts of PA, personality traits, and high school sports participation (sports) and 2) determine significant PA correlates in a college population. Participants: 237 undergraduates at a university in the United States between September 2020 and May 2021 participated. Methods: Participants completed a survey evaluating PA, personality traits, sports, and demographic variables. Pearson partial correlations assessed correlations between different PA domains, personality traits, and sports. Conscientiousness was positively associated with all PA measures (r = .14-.30), except for active transport PA. Sports were related to vigorous and leisure PA. Conscientiousness is related to PA measures and is a significant PA correlate. However, more research is necessary to understand if leisure time PA can enhance Conscientiousness.

College student athlete versus nonathlete mental and social health factors during the COVID-19 pandemic

Objective: This study investigated differences in stress, anxiety, and social support between collegiate student-athletes and nonathletes during the COVID-19 pandemic. Participants: College students enrolled at a NCAA Division III private liberal arts college in the Midwest. Methods: Participants (n = 58) completed a series of surveys each month for 4 months that included the Generalized Anxiety Disorder Questionnaire, Perceived Stress Scale Questionnaire, and Multidimensional Scale of Perceived Social Support Questionnaire. Results: There were significant main effects of time for stress and social support across the 4 months (p < 0.05), but not for anxiety. There was a significant difference in anxiety levels between athletes and nonathletes (p < 0.01), but not for social support or stress (p > 0.05). Conclusions: Nonathletes maintained support networks, or found alternate outlets of support, in addition to coping with anxiety and stress levels when compared to athletes.

Effects of active video games on mental health among college students: a systematic review

BACKGROUND

Mental health significantly impacts college students' academic performance and overall happiness. Active video games (AVGs) have gained popularity among college students due to their ample entertainment, and there is growing interest in utilizing them to address mental health issues. However, there has not been a comprehensive summary and systematic review of research on the effects of AVGs on college students' mental health.

METHODS

As of October 18th, 2024, searches were conducted in six internationally renowned databases (PubMed, SCOPUS, Web of Science, CINAHL Plus, EBSCOhost, Cochrane Library). Inclusion and exclusion criteria were developed based on the PICOS principles. A systematic review was conducted following the PRISMA guidelines, and compliant studies using randomised controlled trial design (RCT) were included. The methodological quality of the included studies was evaluated using the PEDro scale.

RESULTS

A total of 3471 articles were retrieved, of which 17 met the criteria inclusion. The PEDro scores of the 17 studies ranged from four to nine. The results indicate that AVGs can effectively improve college students' poor mental health, such as stress, anxiety, and depression, as well as increase their happiness and psychological satisfaction. Moreover, AVGs have been shown to increase motivation for exercise, improve college students' attitudes toward other forms of exercise, and promote sustained physical activity. Additionally, AVGs have demonstrated efficacy in improving sleep quality.

CONCLUSION

Overall, AVGs can serve as an effective intervention to reduce dysphoria and promote positive psychological states among college students, thus improving mental health. Using the theory-based design of AVGs will further increase the effect. However, the effects of AVGs vary depending on their type and initial design purpose. Therefore, when using AVGs to improve college students' mental health, it is necessary to carefully consider the students' original state, select AVGs with rich game content that can provide at least moderate-intensity physical activity, and adopt the correct intervention strategy to achieve good results. AVG can potentially become a valuable tool for improving college students' mental health.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero , identifier: CRD42024510488.

The relationship between physical activity and psychological sub-health among high altitude region Tibetan college students

Background

The reduction in moderate to vigorous physical activity (MVPA) and the increased prominence of psychological sub-health (PSH) have had a serious negative impact on the health of Tibetan college students. Few studies have been conducted on college student populations at high altitude region in China. Therefore, the study investigated MVPA and PSH in 8721 Tibetan college students to analyze the relationship that exists between them.

Methods

In this study, subjects were selected by cluster sampling method, and 8,721 high altitude region Tibetan college students were questioned about MVPA, PSH, family situation, BMI, and lifestyle. One-way ANOVA, chi-square test, and stepwise logistic regression analysis were used to analyze the relationship between MVPA and PSH.

Results

The proportion of Chinese Tibetan college students at high altitude region with MVPA duration ≤30 Mins/Day, 31-60 Mins/Day, and ≥ 61 Mins/Day were 76.7, 18.7, and 4.7%, respectively. The proportion of Tibetan college students in China experiencing PSH was 16.41%. The percentage of emotional symptoms, behavioral symptoms, and social adaptation difficulties were 17.61, 18.04, and 14.59%, respectively. Logistic regression analysis showed that after adjusting for relevant covariates, Tibetan college students with MVPA ≤30 Mins/Day had a higher odds ratio of PSH compared to college male students with MVPA ≥61 Mins/Day (OR = 2.95, 95% CI: 1.79,4.84). In contrast, there was no significant relationship between MVPA and PSH in college females. Overall, Tibetan college students with MVPA ≤30 Mins/Day had a higher odds ratio of PSH compared to Tibetan college students with MVPA ≥61 Mins/Day (OR = 2.99, 95% CI: 2.00,4.47).

Conclusion

Chinese Tibetan college students from high altitude region areas had lower levels of MVPA and higher rates of PSH. There is an relationship between MVPA time and PSH among high altitude region Tibetan college students, and the incidence of PSH is higher among high altitude region Tibetan college students with shorter MVPA time.

Effects of a Telenutrition Weight Loss Program Supported with Telemonitoring and Telehealth Coaching on Anthropometric and Biochemical Measures in Overweight and Obese Adults: A Pilot Randomized Controlled Trial

BACKGROUND/OBJECTIVES

Telenutrition has been reported to enable dietitians to support outpatients remotely in an accessible and convenient state. The literature shows that both telemonitoring and health coaching are effective approaches for achieving a greater impact on weight loss and the client's compliance with their diet. The purpose of the present study was to assess the impact of a telenutrition weight loss program on weight reduction, supported with telemonitoring and health coaching.

METHODS

A pilot randomized controlled trial was conducted among overweight and obese adults. The control group (n = 11) received a hypocaloric and tailored diet via telenutrition. The intervention group (n = 18) also received a hypocaloric and tailored diet via telenutrition, but it was supported with weekly telemonitoring and monthly telehealth coaching.

RESULTS

Participants who joined the intervention group showed a reduction in weight, BMI, fat %, visceral fat, and WC, whereas participants in the control group only displayed a reduction in WC after a period of 3 months. Comparing between the groups, a greater reduction in weight, BMI, fat %, and visceral fat was seen in the intervention group. Furthermore, muscle % was significantly higher in the intervention group after a period of 3 months. At the 6-month follow-up, the intervention group still showed promising results, but they were not significant.

CONCLUSIONS

Our data indicate that the integration of the three approaches of telenutrition, telemonitoring, and health coaching in dietary weight loss programs can have significant impacts on weight loss in obese and overweight individuals.

Impact of ambient air pollution on physical activity engagement among university students

Introduction

PM2.5 poses significant health risks with prolonged exposure, potentially reducing physical activity levels. This study aims to investigate the impact of ambient PM2.5 levels on physical activity engagement among individuals.

Methods

The retrospective cross-sectional study involved 423 students from Chiang Mai University residing there between January and August 2023. We used the validated Thai version of the International Physical Activity Questionnaire to assess physical activity intensity during high and low pollution periods. Individuals who engage in at least 150 min of moderate-intensity or 75 min of high-intensity physical activity per week meet the recommended physical activity guidelines. Multiple logistic regression analyzed air pollution's relation to physical activity intensity, and Cochran's Q-test compared activity levels across pollution periods.

Results

Recommended physical activity prevalence was 76.36% during high PM2.5 and 71.63% during low PM2.5 periods, it showed higher physical activity during polluted periods (p = 0.049). Individuals' behavior showed a preference for indoor exercise (p < 0.001), consistent PM2.5 level checks (p < 0.001) during high PM2.5 periods. Internal motivation significantly associated with recommended physical activity in both low and high PM2.5 periods (aOR = 2.46, 95% CI = 1.14 - 5.27 and aOR = 4.00, 95% CI = 1.84 - 8.70, respectively). The outdoor exercise significantly associated with the recommended physical activity only during the low PM2.5 period (aOR = 1.72, 95% CI = 1.03 - 2.87).

Conclusion

University students showed increased physical activity intensity during high PM2.5 periods, favoring indoor exercise in polluted environments. This behavioral shift highlights environmental pollution's influence on lifestyle choices and cornering on health outcomes. Government and university support is crucial for implementing measures to mitigate PM2.5 pollution, including promoting safe indoor exercise, enhancing pollution control measures, and developing air quality monitoring and warning systems.

Unhealthy Lifestyle Contributes to Negative Mental Health and Poor Quality of Life in Young University Students

Background: A negative lifestyle is reported to be related to poor mental health and quality of life (QOL). However, there is little information on this in university students. The objective of the present study was to investigate the association between mental health (i.e., anxiety, depression symptoms and stress), QOL, SWLS and lifestyle parameters (i.e., PA, sleep duration, ST and food habits) among Chilean university students and then to determine the differences in mental health, QOL, SWLS and lifestyle parameters according to gender. Methods: This cross-sectional study included a total of 211 university students (128 females and 83 males) aged 18-28 years. Mental health, QOL and lifestyle were measured through validated questionnaires. Results: Bad food habits (lowest score in the food survey) were linked to anxiety (2.3 [0.22-4.36], p = 0.03), depressive symptoms (3.75 [1.54-5.9], p = 0.001) and stress (2.24 [0.31-4.17], p = 0.023). Furthermore, <6 h of sleep was related to poorer mental health (13.5 [7.6-19.5], p = 0.001), anxiety (4.2 [2.0-6.4], p < 0.001), depressive symptoms (5.5 [3.2-7.9], p < 0.001) and stress (3.8 [1.8-5.9], p < 0.001). In addition, ≥4 h of ST was linked positively to negative mental health (8.3 [2.86-13.7], p = 0.003), depressive symptoms (3.45 [1.47-5.4], p = 0.001) and anxiety (3.2 [1.05-5.4], p = 0.004). Non-physical activity was related to the scores for anxiety (2.6 [0.20-5.0], p = 0.030), depression (2.7 [0.009-5.3], p = 0.049) and stress (2.4 [0.12-4.7], p = 0.039). Conclusions: this study showed that unhealthy lifestyle factors (i.e., insufficient sleep, lack of PA and prolonged ST) were strongly associated with poorer mental health and QOL in university students. These findings highlight the importance of addressing these aspects of lifestyle in intervention and health promotion programs aimed at young university students in order to improve their mental health and overall QOL.

Replacement of sedentary behavior with various physical activities and the risk of incident depression: a prospective analysis of accelerator-measured and self-reported UK Biobank data

PURPOSE

To examine the dose‒response relationships of sedentary behavior (SB) and physical activities (PAs) with depression, and to explore the effects of replacing SB with PAs on depression risk.

METHODS

The study used data from UK Biobank aged 37 to 73 years. Light physical activity (LPA), moderate-to-vigorous activity (MVPA), sleep duration, and total sedentary behavior (TSB) were measured by accelerometers. Self-reported SB was also adopted when daily screen-sedentary behavior time (SSB) and leisure-sedentary behavior time (LSB) were the focus. Incident depression was obtained from the part of mental and behavioral disorders in the "first occurrence fields" of UK Biobank. A Cox proportional hazard model and isotemporal substitution model were performed to explore the associations of LPA, MVPA, TSB, LSB, SSB, and sleep on depression and the effects of replacing SB time with equal PA time.

RESULTS

Highest levels of MVPA (HR = 0.58, 95%CI: 0.50-0.68) were associated with decreased depression risk compared with the lowest level (Q1). Longer SSB time (HR = 1.18, 95%CI: 1.06-1.32), LSB time (HR = 1.19, 95%CI: 1.07-1.32), and TSB time (HR = 1.17, 95%CI: 1.00-1.38) could increase depression risk significantly. Replacing 1h/day TSB, SSB, and LSB with MVPA brought the greatest risk reductions [31% (HR = 0.69, 95%CI: 0.62-0.77), 30% (HR = 0.70, 95%CI: 0.65-0.77), and 29% (HR = 0.71, 95%CI: 0.65-0.77)]. Under the same conditions, the effects of LPA replacement were also significant, but weaker than those of MVPA. Subgroup analyses showed that replacing 1h/d TSB with LPA could significantly decrease the depression risk for the females, but not for the males.

CONCLUSION

Large benefits for reducing the risk of incident depression could be attained by replacing a period of TSB, SSB, or LSB with equal PA time, especially for MVPA. Regular PA and less SB were recommended for improving mental health.

Sociodemographic Variables and Psychological Distress of Moroccan College Students

Because college students are an important category of the population highly vulnerable to mental health problems, this study aims to investigate the sociodemographic variables associated with the increase in psychological distress levels among Moroccan college students. Participants (N = 1147; mean age 20.00, SD = 2.6; 703 females and 444 males) completed a survey, which included a sociodemographic questionnaire and the Arabic version of the Brief Symptoms Inventory (BSI). Non-parametric tests were conducted to explore the data. Non-parametric tests revealed that being female, having a physical illness, experiencing depression and anxiety, having sleep problems, and living with only their mother or with a family member other than their parents are associated with a significant increase in the level of psychological distress. In summary, specific sociodemographic factors exert a notable influence on the psychological distress levels experienced by college students. Consequently, it is imperative to intensify research endeavors aimed at delving into the intricacies of college students' mental health and its correlated ramifications.

The effects of university badminton class on health and well-being in untrained college students

This study investigated the effects of a 6-week activity course on health and well-being in untrained college students. Twenty-two participants (ages 18-23) engaged in either badminton or soccer twice a week. Using Badminton World Federation (BWF) Shuttle Time Lesson Plans, both groups showed significant improvements in the quadrant jump and standing long jump tests, with badminton participants demonstrating greater gains in the quadrant jump. In addition, Resilience levels increased in both groups and exercise self-efficacy saw a larger rise in the soccer class. The data suggested that badminton might improve agility more due to the need for rapid direction changes in a smaller court. Further, university activity classes could enhance both physical and mental well-being, though prior soccer experience and limited badminton court access may boost self-efficacy more in soccer participants. Lastly, BWF Shuttle Time Lesson Plans proved effective for introducing badminton to beginners.

Microaggression and discrimination exposure on young adult anxiety, depression, and sleep

BACKGROUND

Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression - subtle/ambiguous slights against one's marginalized identity - is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups.

METHODS

Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure.

RESULTS

Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (ORMicro = 1.42, ORDiscrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (ORDepress = 1.24, ORSleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents.

LIMITATIONS

Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences.

CONCLUSIONS

The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits.

Health risk behaviors among medical and nursing students of Lumbini Medical College, Nepal: A cross-sectional study

Background and Aims

Healthcare students are expected to lead healthy lives yet they may engage in health risk behaviors (HRBs) like physical inactivity, poor diet, and substance use. These behaviors can have negative consequences for both the individual's health and well-being, as well as their ability to perform their future roles as healthcare providers. This study aimed to assess the prevalence of HRBs and associated factors among medical and nursing students at Lumbini Medical College, Nepal.

Methods

A cross-sectional study was conducted among 412 undergraduate healthcare students using a self-administered questionnaire. HRBs across various domains were assessed. Validated scales screened for anxiety and depression. Regression analyses determined associations between mental health and HRBs.

Results

Low physical activity was prevalent, with only 10.7% exercising ≥5 times/week. Inadequate fruit/vegetable intake (1-2 servings/day) was reported by 79.9% students. Short sleep duration (5-6 h) on weeknights (51.2%) was common. More than three quarter (76.5%) of students met the screening cutoff score for HRBs. The study highlighted that students with addiction, depression and anxiety are more likely to exhibit HRBs (p < 0.01).

Conclusion

Multiple HRBs were highly prevalent among the students. A considerable proportion demonstrated a clustering of risky lifestyle factors, which were linked to poor mental health. Interventions should address academic burden, promote positive health behaviors, and target mental well-being in this vulnerable group.

Ramadan fasting observance is associated with decreased sleep duration, increased daytime sleepiness and insomnia symptoms among student-athletes

OBJECTIVE

To examine the relationships between Ramadan fasting observance (RFO) and sleep-wake patterns, daytime sleepiness, and insomnia levels in student-athletes.

METHODS

Sleep was measured using wrist-actigraphy in 25 semi-professional student-athletes (mean ± SD; age = 22 ± 2 years, height = 182.0 ± 5.8 cm, body mass = 81.3 ± 15.2 kg) during seven nights before RFO (academic study period), during the first half of RFO (14 nights, holiday period), and the second half of RFO (14 nights, academic study period). Additionally, participants completed the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires seven days before RFO and on the last day of RFO.

RESULTS

Actigraphy results indicated RFO was associated with significant decreases in sleep duration during the second half of RFO vs. before and during the first half of RFO (p < 0.001). However, the first half of RFO was associated with a delay of ⁓ 2.5 h in sleep onset compared to before RFO; this delay persisted during the second half of RFO (p < 0.001). The total PSQI score before RFO (6.6 ± 2.3 AU) and during RFO (8.2 ± 2.3 AU) suggested poor overall sleep quality. ISI and ESS scores were greater during than before RFO (p = 0.002 and p = 0.041, respectively).

CONCLUSIONS

The second half of RFO was associated with decreases in objectively assessed sleep duration among student-athletes. RFO was also associated with impaired sleep quality, excessive daytime sleepiness, and increased insomnia symptoms. Personalized interventions to address sleep-related issues in student-athletes during RFO are warranted.

Association of Accelerometer-Measured Physical Activity With College Student Success and Retention

BACKGROUND

This study examined the relationship between physical activity (PA) and academic performance and retention among college students using accelerometer data while controlling for sex and socioeconomic background.

METHODS

Data were collected from 4643 first-year college students at a private university in the south-central United States who began their studies in the Fall semesters between 2015 and 2022. Daily step counts were collected using accelerometers worn as part of the institutions PA requirements. The expected family contribution was calculated based on information provided on the Free Application for Federal Student Aid. Grade point average (GPA) and retention data were collected directly from official university databases.

RESULTS

Female students generally had lower median age and steps count and a higher median GPA than males. The retention rates from fall to spring and fall to fall were 95.9% and 83.8%, respectively, with no significant difference in retention rates between males and females. GPA was significantly positively correlated with steps, expected family contribution, and age, and negatively correlated with being male and having an expected family contribution of zero. The fall to spring retention rate was significantly positively correlated with steps and GPA.

CONCLUSIONS

The study's findings suggest that increasing levels of PA, as measured by daily step counts, may be effective in promoting academic performance and retention, even when controlling for sex and socioeconomic background. The use of device-based measures of PA in this study contributes to the literature on this topic, and policymakers and educational institutions should consider interventions focused on academic performance and physical activity to help students persist.

Mental health issues of higher education students reflected in academic research: A text mining study

Objective: This study investigated mental health issues among higher education students to identify key concepts, topics, and trends over three periods of time: Period 1 (2000-2009), Period 2 (2010-2019), and Period 3 (2020-May 2024). Methods: The study collected 11,732 bibliographic records from Scopus and Web of Science, published between January 2000 and May 2024, and employed textual analysis methods, including keyword co-occurrence analysis, cluster analysis, and topic modeling. Results: In Period 1, general topics related to mental health disorders and treatments were identified. Period 2 showed prominence of well-being and help-seeking, as well as the emergence of digital mental health. Period 3 emphasized the impact of COVID-19 and increased technology usage. Conclusions: Based on the findings, we discussed the significance of the study and practical implications for clinicians and policymakers, as well as methodological implications for researchers. Additionally, the limitations of the study and future research were addressed.

Physical activity and social anxiety symptoms among Chinese college students: a serial mediation model of psychological resilience and sleep problems

BACKGROUND

Social anxiety symptoms are common and harmful psychological illness in college students. Although some studies have illustrated that physical activity could reduce social anxiety symptoms, the specific mechanism is still unclear. Based on theoretical studies on resilience and sleep, this study constructed a serial mediation model to explore whether they mediate between physical activity and social anxiety symptoms among college students.

METHODS

This study surveyed 9,530 college students from three colleges in China to explore the mediating effect of physical activity and sleep problems between physical activity and social anxiety symptoms. Participants were investigated with the International Physical Activity Questionnaire, Connor-Davidson Resilience Scale, Sleep-related problems, and the Social Interaction Anxiety Scale and the Social Phobia Scale. Correlations between variables were analysed using Pearson correlation analysis and mediation analyses were performed using SPSS PROCESS macro 3.3 software.

RESULT

The study found that physical activity was negatively associated with social anxiety symptoms and sleep problems, but positively with psychological resilience. After controlling for sociodemographic variables, physical activity can not only indirectly alleviate social anxiety symptoms through the separate mediation of psychological resilience and sleep problems, but also through the serial mediation of psychological resilience and sleep problems.

CONCLUSION

These results suggest that improving physical activity levels could reduce social anxiety scores by increasing psychological resilience and sleep quality. This is of great reference significance for the prevention and intervention of college students' mental health.

Exercise, mental well-being and burnout in Thai medical students in 2020-2021: an online cross-sectional survey

INTRODUCTION

Within the Thai medical curriculum, its rigorous education framework, demanding schedules and high academic standards can contribute to psychological distress. Regular physical activity has consistently shown positive effects on mental health. The aim of the study was to investigate the association between exercise and psychological well-being, including depression, anxiety, and burnout, in Thai medical students, and factors related to insufficient exercise and depression.

METHODS

The cross-sectional study was conducted among medical students in the university hospital during 2020-2021. Participants completed self-administered questionnaires consisting of demographic data, Godin-Shephard Leisure-Time Physical Activity Questionnaire, depression screening (9Q), Thai General Health Question-28 (4 domains: somatic symptoms, anxiety and insomnia, social dysfunction, severe depression), and Maslach burnout inventory (Emotional exhaustion (EE), Depersonalization (DP), Reduced Personal Achievement (rPA).

RESULTS

Of the 404 participants, 50.5% were women, the mean age (SD) was 21.06 (1.8) years, and 52% were in clinical years. The prevalence of insufficient exercise was 59.6%, depression (30.2%), somatic symptoms (27.7%), anxiety (30.7%), insomnia (89.4%), social dysfunction (89.4%), high level of EE (32.4%), DP (21%), and rPA (56.7%). Insufficient exercise was associated with moderate to severe depression (OR 2.89, 95% CI 1.16-7.25), anxiety and insomnia (OR 1.56, 95% CI 1.01-2.43), social dysfunction (OR 2.51, 95% CI 1.31-4.78), burnout in part due to high rPA (OR 2.4, 95% CI 1.4-4.13), and study in clinical years (OR 1.91, 95% CI 1.28-2.87). After adjusted significant factors, only studying in the clinical year, social dysfunction, and burnout in part of rPA were related to insufficient exercise.

CONCLUSIONS

High rates of insufficient exercise, psychological challenges, and burnout were prevalent among medical students. To effectively address these issues, medical school should advise students to participate in regular exercise, promoting mental well-being and healthier lifestyles.

The Connection between Sleep Patterns and Mental Health: Insights from Rural Chinese Students

BACKGROUND

The association between sleep patterns and young students' mental health, which is crucial for their development, remains understudied in rural China. Therefore, the relationship between sleep patterns and mental health among primary and junior high school students in rural China was examined.

METHOD

A total of 1592 primary and junior high school students from rural areas of Gansu Province were surveyed, and the Depression Anxiety and Stress Scale (DASS) was utilized to assess mental health, alongside self-reported data on their daily sleep patterns.

RESULTS

Significant sleep inadequacies were identified: 28% of students received less than 8 h of sleep on weekdays, and 19% went to bed later than recommended. On weekends, 38% of students had delayed bedtimes, though only 7.2% received less than 8 h of sleep. Notably, a "U-shaped" relationship was uncovered between sleep duration and mental health for students on weekends, with optimal mental health correlated with receiving 10-11 h of sleep, while both shorter and longer sleep durations on weekends worsened outcomes. This pattern is absent on weekdays. Additionally, adequate sleep and an earlier bedtime was linked to a 6-8% decrease in mental health risks.

CONCLUSIONS

These findings provide valuable insights for policymakers seeking to enhance student mental well-being in rural settings, emphasizing the importance of implementing measures that promote balanced sleep habits among young students.

The Relationship between Lifestyle Behaviors and Mental Illness in Women in College

Women, particularly those in college, have the highest prevalence of any mental illness (MI), which negatively impacts social connection, academic performance, and health. Research into alternative treatment methods suggests that lifestyle behaviors are safer and more effective than medication at reducing MI symptoms. This study explores the relationship between lifestyle behaviors and MI in college women through an online survey. The survey included a food frequency questionnaire (Diet History Questionnaire II) and questions about lifestyle behaviors, symptoms of MI, and sociodemographic information. Diet quality was calculated using the Healthy Eating Index (HEI), and MI was assessed using the Depression, Anxiety, and Stress Scale-21. Independent sample t-tests, ANOVA, and chi-square analyses were conducted. A total of 222 women completed the survey. Overall, diet quality was poor, with a mean HEI of 62.6 ± 10.4. No significant differences or associations were found between MI groups for total HEI score, sleep, or tobacco use. However, alcohol use was significantly associated with MI (p = 0.049). Individuals with fewer concurrent unhealthy lifestyle behaviors had less severe symptoms of depression (p = 0.009) and anxiety (p < 0.001) compared to those with more unhealthy lifestyle behaviors. In this study, alcohol use was the only independent lifestyle behavior associated with symptoms of MI. We also found an association between the number of concurrent unhealthy lifestyle behaviors and depression and anxiety symptoms. Future research should explore the benefits of a healthy lifestyle on MI in a more diverse sample of women.

Physical Activity and Mental Health of Employed Adults: Mediation and Moderation Effects of Beliefs in the Benefits of Physical Activity

Numerous studies have shown physical activity (PA) improves psychological functioning and well-being. However, the underpinning processes and mediating variables are less known. There is evidence that beliefs about the benefits of PA contribute to physical health, regardless of actual PA. By applying these findings in the context of mental health, we sought to investigate the role of belief in the benefits of PA in the relationship between self-reported PA and mental health. A total of 381 employed adults completed the Godin Leisure-Time Exercise Questionnaire, Center for Epidemiologic Studies Depression Scale, and Anxiety subscale of the Emotional state scale. Furthermore, participants reported the degree to which they believe that PA has benefits for their psychological health. The mediation analysis shows that greater PA intensity was associated with lower levels of depression and anxiety. Additionally, belief in the benefits of PA on psychological health had a mediating role. Specifically, more intensive PA was related to a stronger belief in PA benefits, subsequently leading to reduced levels of depression and anxiety. We discuss the neurobiological mechanisms underlying the relationship between PA and mental health, alongside the significant role of mindset.

Effects of Transition from Remote to In-Person Learning in University Students: A Longitudinal Study

Previous studies have shown that the transition from the University environment to remote learning impacted student mental health. Our study aimed to investigate the effects of university environment on anxiety and depressive symptoms in health sciences students. Students at the Technical University of Manabí, Ecuador, with 6-10 in-person semesters, who shifted to remote learning and then returned to face-to-face learning were selected. Students responded to the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). In addition, questions regarding social interaction, physical exercise, mood and sleep habits were also asked. This longitudinal study tracked 323 students during the return to in-person classes and term end. The results showed similar rates of anxiety (GAD-7, p = 0.011-p = 0.002) and depression (PHQ-9 p = 0.001-p = 0.032) among students at week 1 and week 15. Previous diagnosis of depression (OR, 0.171; CI 0.050-0.579, p < 0.005) was shown to correlate with depression levels in week 1, with no changes seen at follow-up. Anxiety levels were shown to be associated with a previous diagnosis of the disorder at week 1, but not at follow-up (OR 0.233; CI 0.085-0.643, p < 0.005). The return to in-person learning among university students maintained levels of anxiety and depressive symptoms, underscoring ongoing vulnerabilities to mental health disorders in this group.

The relationship between self-determined motivation, emotional involvement, cognitive involvement and leisure-time physical activity among college students

Objective

Grounded in self-determination theory and the stimulus-organism-response framework, this study examines factors that affect college students' leisure-time physical activity by considering the basic psychological needs satisfaction (i.e., autonomy, competence, and relatedness), self-determined motivation, emotional and cognitive involvement.

Methods

The sample included 526 students (47.8 % male; 57.2 % female) from four universities in central China. A structural equation model was used to analyze associations among variables.

Results

The satisfaction of all three basic psychological needs had a significant positive impact on emotional involvement. Additionally, autonomy and competence need satisfaction had a significant positive impact on self-determined motivation and cognitive involvement. However, contrary to our expectation, there was no significant effect of relatedness need satisfaction on self-determined motivation and cognitive involvement. Furthermore, emotional involvement was found to have a significant effect on leisure-time physical activity intention for male students. Interestingly, the relationship between cognitive involvement and leisure-time physical activity intention is significant, but this effect was observed only among female students.

Conclusion

Pedagogical strategies and tactics better satisfied students' psychological needs, promote physical education classes emotional and cognitive involvement, therefore, achieve autonomous active lifestyle behaviors in leisure time.

Domain matters: An examination of college student physical activity participation patterns by gender and race/ethnicity

BACKGROUND

Physical activity (PA) consists of multiple domains, including leisure-time PA (LTPA), occupational PA (OPA), and transportation PA (TPA), though limited research has examined these domains among college students.

METHODS

This cross sectional, online survey asked undergraduate students to self-report demographics (gender, race/ethnicity, employment) and PA (LTPA, TPA, and OPA). Participants were categorized as meeting/not meeting current aerobic PA recommendations with only LTPA and with all domains of PA. Analyses examined differences by domain and demographics.

RESULTS

For participants (n = 3732) when only considering LTPA, 79% met recommendations, while considering all forms of PA resulted in 94% of students meeting recommendations. Gender and race/ethnicity differences in the odds of meeting PA recommendations were present with only LTPA, however when considering all PA domains, some disparities were no longer present.

CONCLUSIONS

These findings highlight how different domains of activity contribute to overall PA and the relationship with gender and race/ethnicity.

Anxiety, Depression, and Quality of Sleep Vary in Their Correlation to Postoperative Outcomes of Rotator Cuff Repair: A Prospective Study

Background/Objectives: Recent studies imply that psychological factors and sleep quality play a role in the outcomes of surgical procedures, including in orthopedic surgery. The aim of the present study is to evaluate possible correlations between preoperative depression, anxiety, and quality of sleep and functional 6-month postoperative scores in patients having undergone rotator cuff repair (RCR). Methods: All patients included in the study performed the Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires preoperatively and 36-item Short-Form Health Survey (SF-36), Oxford Shoulder Score (OSS), Shoulder Pain and Disability Index (SPADI), and PSQI questionnaires at the six-month postoperative follow-up. A total of 47 patients were included in the analysis. Results: Statistically significant differences between preoperative anxious and not-anxious groups were found in the postoperative SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores and PSQI score. The correlation of the preoperative depression score to postoperative outcome measures revealed a strong positive correlation between the preoperative HADS-D score and the 6-month PCS, MCS, and OSS scores. The correlation of preoperative sleep quality to postoperative outcome measures revealed a strong positive correlation between the preoperative PSQI score and 6-month MCS score. Conclusions: Anxious patients had worse postoperative RCR outcomes. Depression may be influenced by factors related to RC pathology; however, there were no statistically significant correlations. Sleep quality generally improves postoperatively, and no significant association was found between bad preoperative sleepers and worse outcomes.

Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents

Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.

Positive and Negative Correlates of Psychological Well-Being and Distress in College Students' Mental Health: A Correlational Study

BACKGROUND

Recognizing the positive or negative effects of students' mental health promotes personal development, well-being, and academic success. Academic life exposes college students to multiple adjustments, demands, and vulnerabilities that can cause stress and mental health problems. This study aims to identify psychological well-being and psychological distress effects on college students' mental health.

METHODS

A correlational study was designed involving a non-probabilistic 560 sample of students (446 women) aged 18 to 41 years (M = 19.6; SD = 1.68). An online self-report questionnaire was used including demographic, relational, academic, and health behaviors variables, and the measures: Mental Health Inventory; Satisfaction with Social Support Scale; Academic Life Satisfaction Scale; and Psychological Vulnerability Scale.

RESULTS

Regression analyses indicate that male students, dating, good academic performance, exercise, sleeping seven hours, satisfaction with social support, and academic life satisfaction were significant correlates (p < 0.05) of psychological well-being, with the last two having great weight in the model. Females, low income, aged 21-24 years, sleeping less than 6 h, moderate psychological vulnerability, and perception of vulnerability were significant (p < 0.05) negative effects of psychological distress.

CONCLUSIONS

This study addresses the positive and negative effects of psychological well-being and distress in college students. Specific mental health promotion and morbidity prevention programs can improve students' mental health literacy and resilience.

The effect of physical fitness on psychological health: evidence from Chinese university students

BACKGROUND

Despite frequent discussions on the link between physical and mental health, the specific impact of physical fitness on mental well-being is yet to be fully established.

METHOD

This study, carried out between January 2022 and August 2023, involved 4,484 Chinese University students from eight universities located in various regions of China. It aimed to examine the association between physical fitness on psychological well-being. Descriptive statistics, t-tests, and logistic regression were used to analyze the association between physical fitness indicators (e.g., Body Mass Index (BMI), vital capacity, and endurance running) and mental health, assessed using Symptom Checklist-90 (SCL-90). All procedures were ethically approved, and participants consented to take part in.

RESULTS

Our analysis revealed that BMI, vital capacity, and endurance running scores significantly influence mental health indicators. Specifically, a 1-point increase in BMI increases the likelihood of an abnormal psychological state by 10.9%, while a similar increase in vital capacity and endurance running decreases the risk by 2.1% and 4.1%, respectively. In contrast, reaction time, lower limb explosiveness, flexibility, and muscle strength showed no significant effects on psychological states (p > 0.05).

CONCLUSION

Improvements in BMI, vital capacity, and endurance running capabilities are associated with better mental health outcomes, highlighting their potential importance in enhancing overall well-being.

Evaluation of Depression and Its Correlates in Terms of Demographics, Eating Habits, and Exercises Among University Students: A Multicenter Cross-Sectional Analysis

Background

University students are a vulnerable population prone to mental health challenges. This study aimed to investigate depression and its associated factors among university students in terms of demographics, eating habits, and exercises.

Methods

A total of 2891 university students from three universities participated in this study between January 2024 and February 2024. An online survey questionnaire was distributed using a snow-ball strategy. The survey collected demographic, lifestyle, and psychological data, including depression and anxiety scores using the PHQ-9 and GAD-7 screening tools. Subgroup analysis was conducted according to sport frequency and sport type using Chi-square test for qualitative data and t-test for quantitative data. Multiple linear regression analysis was performed to identify risk factors for depression.

Results

A total of 44.2% and 39.5% of the participants reported symptoms of depression and anxiety, respectively. Significant differences were observed in various characteristics across different sport frequency groups, with participants with higher sport frequency tending to have less depression (P<0.001) and anxiety (P<0.001) symptoms. As the frequency of weekly exercise increased, anxiety and depression scores gradually decreased. The mean PHQ-9 and GAD-7 scores were highest in the group with no sports and lowest in the group with a sport frequency of 3-4 times per week (P<0.001). Additionally, once exercise frequency reached 5 times per week or more, anxiety and depression scores no longer decreased. Subgroup analysis based on sport type revealed that participants engaging in specific sports, such as basketball, tennis, dance, and running, had lower depression (P<0.001) and anxiety (P<0.001) scores compared to the overall average. Based on multiple linear regression analysis, married status (P=0.036), enjoying barbecue food (P<0.001), prolonged sedentary time (P=0.001), experiencing stress events (P<0.001), and electronic device usage time (P<0.001) were positively associated with depression scores, while loving eating vegetables (P=0.007), a relatively longer sport time (P=0.005), a higher exercise frequency (P=0.064), and no chronic disease (P<0.001) were negatively associated with depression scores.

Conclusion

This study highlights the importance of a healthy lifestyle, including regular exercise, limited exposure to electronic screens, and a balanced diet, in preventing and mitigating depression among university students. This study also suggests that exercising 3-4 times a week is associated with the lowest levels of anxiety and depression. Activities such as basketball, tennis, dance, and running are effective in alleviating these mental health issues through regular exercise.

Sleep Quality and Interoception Are Associated with Generalized Anxiety in Baccalaureate Nursing Students: A Cross-Sectional Study

Baccalaureate nursing students are at increased risk for anxiety and related mood disorders. We conducted a cross-sectional study to explore the relationships among anxiety symptoms measured by the Generalized Anxiety Disorder (GAD-7) questionnaire and lifestyle behaviors including habitual diet, sleep quality (Pittsburg Sleep Quality Index [PSQI]), and physical activity. Descriptive statistics were obtained for sample characteristics, and Pearson correlations and backward stepwise linear regression explored relationships between the GAD-7 scores, the Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2) subscales, and other variables. Sixty-eight students completed the survey, with 38% having moderate-to-severe anxiety. On average, respondents had moderate diet quality (Healthy Eating Index median 60/100 [range 51-75]), had high sleep quality (PSQI median 7/21 [range 4-10]), and were highly active, with a median of 43 (range 24-78) weekly metabolic equivalent (MET) hours. Sixty-seven out of 68 respondents indicated a willingness to change lifestyle behaviors; the most prevalent time-related factors were school and social commitments, with stress and financial constraints being reported among half or more of respondents. Regression analysis determined that PSQI (β = 0.446) and the MAIA-2 Not-Worrying subscale (β = -0.366) were significant (p < 0.001 for both) predictors of anxiety severity. These results indicate that mindfulness and sleep hygiene may be the most actionable foci for interventions to reduce anxiety in baccalaureate nursing students. This study was not registered as a clinical trial.

The Prevalence of Depression and Anxiety and Its Association with Sleep Quality in the First-Year Medical Science Students

Methods

A total number of 471 freshmen students (NUMS) participated in the study, pinpointing that the data are collected in 2019 and 2020. In line with measuring depression, anxiety, and sleep quality, the Persian Beck Depression Inventory-II, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index were employed. The associations between depression and anxiety with sleep quality were assessed by using the multiple logistic regression model. All statistical analyses were conducted in STATA14, and the significant level was set at P < 0.05.

Results

The prevalence of depression, anxiety, and poor sleep quality in the study population was 21.4%, 31.9%, and 28%, respectively. Analytical analyses indicated that after adjusting for studied covariates, the odds of poor sleep quality in individuals with depression were 3.5 times higher compared to the counter group (P < 0.001). Moreover, the odds of poor sleep quality in individuals with anxiety were 2.1 times higher compared to the counter group (P < 0.001).

Conclusion

Noticeable proportion of freshmen students suffer from depression and anxiety; in line with such a critical issue, our study found that depression and anxiety had a statistical association with sleep quality in study population. From this respect, it seems that providing essential interventions and psychological counseling services could be constructive for the freshmen medical students.

Prevalence and related factors of sleep quality among Chinese undergraduates in Jiangsu Province: multiple models' analysis

Background and aims

In China, a significant number of undergraduates are experiencing poor sleep quality. This study was designed to investigate the prevalence of poor sleep quality and identify associated factors among undergraduates in Jiangsu Province, China.

Methods

A total of 8,457 participants were collected in 2022 using whole-group convenience sampling. The factors studied included basic demographics, family and social support, personal lifestyles, physical and mental health, mobile phone addiction index (MPAI), and the Connor-Davidson resilience scale (CD-RISC). The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Four models, including weighted multiple linear regression, binary logistic regression, weighted linear mixed model, and logistic regression with random effects, were applied to identify associated factors for sleep quality.

Results

Of the 8,457 participants analyzed, 26.64% (2,253) were classified into the poor sleep quality group with a PSQI score >7. No significant relationship was found between sleep quality and gender, native place, economic level of family, physical exercise, dormitory light, dormitory hygiene, and amativeness matter. Risk factors for sleep quality identified by the four models included lower CD-RISC, higher MPAI, fourth grade or above, smoking, drinking, greater academic pressure, greater employment pressure, roommate sleeping late, noisy dormitory, poorer physical health status, poorer mental health status, and psychological counseling.

Conclusions

These findings provide valuable insights for university administrators, enabling them to better understand the risk factors associated with poor sleep quality in undergraduates. By identifying these factors, administrators can provide targeted intervention measures and counseling programs to improve students' sleep quality.

Impact of Baseline Anxiety on Well-being in People with Post-COVID-19 Condition: A Secondary Analysis

BACKGROUND

Post-COVID-19 condition (PCC) is associated with a host of psychopathological conditions including prominent anxiety symptoms. However, it is not known what effect anxious symptoms have on measures of well-being in individuals living with PCC. This study aims to evaluate anxiety's association with measures of well-being in people with PCC.

METHODS

This is a post hoc analysis utilizing data from a placebo-controlled, randomized, double-blind clinical trial assessing the effect of vortioxetine on cognitive impairment in individuals with PCC (NCT05047952). Baseline data with respect to anxiety and well-being were collected using the Generalized Anxiety Disorder Scale, 7-Item (GAD-7), and the World Health Organization (WHO) Well-Being Index, 5-Item (WHO-5), respectively. A generalized linear model (GLM) analysis on baseline GAD-7 and WHO-5 scores was conducted with age, sex, employment status, education level, previous major depressive disorder (MDD) diagnosis, and confirmed COVID-19 cases as covariates.

RESULTS

Data was analyzed in a sample of 144 participants (N = 144). After controlling for the aforementioned covariates, the results found that GAD-7 and WHO-5 scores had a significant negative correlation (β = -0.053, p = <0.001), signifying that increased anxiety had adverse effects on the overall well-being of individuals with PCC.

CONCLUSION

Herein, we observed a clinically meaningful level of anxiety in individuals with PCC. We also identified a robust correlation between anxiety in PCC and measures of general well-being. Our results require replication, providing the impetus for recommending screening and targeting anxious symptoms as a tactic to improve general well-being and outcomes in individuals with PCC.

The effect of anxiety on sleep disorders in medical students: a moderated mediation model

The relationship between anxiety and sleep disorders is a key research topic in the academic community. However, evidence on the mechanism through which anxiety influences sleep disorders remains limited. The purpose of this study was to investigate the roles of flourishing and neuroticism in the mechanism through which anxiety influences sleep disorders in medical students. We constructed a moderated mediation model and tested the mediating role of flourishing and the moderating role of neuroticism in medical college students. The results showed that: (1) anxiety was significantly and positively related to sleep disorders and significantly and negatively related to flourishing; flourishing was significantly and negatively related to sleep disorders; neuroticism was significantly and positively related to sleep disorders; (2) flourishing had a mediation effect on the relationship between anxiety and sleep disorders; (3) neuroticism moderated the process through which flourishing mediated the effect of anxiety on sleep disorders. Our research expands the literature on the mechanism underlying the effects of anxiety on sleep disorders and provides insights into the potential prevention and intervention of sleep and emotional problems in medical students.